What Are Some Examples Of Pre-Existing Conditions?

Pregnant women with pre-existing medical conditions, such as anemia, autoimmune disorders, blood clotting disorders, cancer, and diabetes, need to be monitored to reduce the chance of complications during pregnancy. These conditions can affect both maternal morbidity and mortality, and complications during pregnancy can increase the prevalence of chronic health issues.

Pre-existing conditions can affect pregnancy or be affected by pregnancy, and they require the clinical care of a doctor or other healthcare professional. Examples of pre-existing conditions include anemia, autoimmune disorders, blood clotting disorders, cancer, diabetes, epilepsy, seizure disorders, chronic hypertension, endocrine disorders, hypercoagulability infections, valvular heart disease, and other autoimmune disorders.

Pregnancy before enrollment is also considered pre-existing and chronic. Other less severe conditions such as acne, asthma, anxiety, and sleep apnea may also affect a developing baby. Pre-existing conditions can range from high blood pressure to past instances of cancer, and insurance companies can no longer charge more or deny coverage to individuals or their children due to these conditions.

Insurance companies can no longer charge more or deny coverage to individuals or their children because of a pre-existing health condition like asthma, diabetes, or cancer. It is important to inform your GP, obstetrician, and/or midwife about any pre-existing physical or mental health conditions, including any previous surgery (including cosmetic procedures).


📹 Is pregnancy a medical condition for insurance – Is pregnancy considered a preexisting condition

Health Coverage Options for Pregnant or Soon to Be Pregnant. Health coverage if you’re pregnant or plan to get pregnant.


How far back is a pre-existing condition?

A pre-existing medical condition refers to a disease, illness, or injury that has been present for at least five years before the individual’s joining date. Health insurance typically doesn’t cover pre-existing conditions. Chronic conditions are persistent, long-lasting, and require ongoing treatment, rehabilitation, or special training. They can continue indefinitely, have no known cure, and may return or be likely to return.

They require ongoing monitoring through consultations, examinations, check-ups, and tests. These conditions are often life-long and limiting in quality of life, and can only be managed through medication, diet, or lifestyle changes.

What are classed as pre-existing medical conditions?

A pre-existing medical condition (PEMC) is defined as an illness or injury that was present prior to the creation or renewal of a policy. Such conditions may include, for example, diabetes, asthma, high cholesterol, or a long-term back condition. It is not uncommon for insurance companies to decline claims associated with pre-existing medical conditions. In some cases, insurance policies are individually underwritten, necessitating that applicants furnish specific information.

What is considered a pre-existing illness?

Insurance companies are prohibited from denying coverage for pre-existing health conditions, such as asthma, diabetes, or cancer, or from imposing higher premiums, until new health coverage becomes effective. This stipulation pertains to both pre-existing conditions and coverage for pregnancy and childbirth.

Is a birth defect a pre-existing condition?

A congenital condition is defined as an abnormal condition that is present at the time of birth and may not be identified until years after the birth. In such cases, the condition is considered to be pre-existing.

Which is an example of a pre-existing condition?

Pre-existing conditions are medical illnesses or injuries that are present before a new health care plan is established. Examples include diabetes, chronic obstructive pulmonary disease (COPD), cancer, and sleep apnea. The ACA made it illegal for health insurance companies to deny coverage or raise rates due to pre-existing conditions. Examples include chronic illnesses like cancer, diabetes, lupus, epilepsy, and depression, pregnancy before enrollment, and less severe conditions like acne, asthma, anxiety, and sleep apnea.

Can you get maternity insurance if you are already pregnant?
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Can you get maternity insurance if you are already pregnant?

Maternity insurance comes with waiting periods, which can range from 9 months to 2 years, depending on the policy. If you are already pregnant, you must wait a minimum of 9 months to claim maternity benefits. However, you can still get hospital coverage if you have a health insurance plan.

When to buy maternity insurance depends on your life stage and the rising costs of medical care. Young couples starting a family should purchase comprehensive maternity insurance as early as possible, as health insurance may not cover maternity benefits if you are already pregnant.

Some situations when buying a maternity insurance plan are: newly married couples planning for their future, couples below 40 years of age without children, women planning to have a second baby, couples planning to get married within 2 to 3 years, and working professionals planning to have kids later.

By buying a maternity insurance plan, you can avoid the waiting period when you need to avail benefits during pregnancy.

What is considered a pre-existing condition?

Insurance companies are prohibited from denying coverage for pre-existing health conditions, such as asthma, diabetes, or cancer, or from imposing higher premiums, until new health coverage becomes effective. This stipulation pertains to both pre-existing conditions and coverage for pregnancy and childbirth.

Is pregnancy a preexisting condition?

In the past, insurance companies could deny coverage for individuals who were pregnant due to pre-existing conditions. However, health plans no longer can charge more for coverage due to pregnancy, and premiums cannot be increased based on sex or health condition. To find the best coverage, consider whether your employer or partner’s employer offers health insurance, as most employers share the cost of insurance premiums with employees. You can also shop for coverage in the health insurance marketplace or exchange, and you may qualify for Medicaid in your state if your income is low.

What is a preexisting maternal disease?
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What is a preexisting maternal disease?

Pregnant individuals with preexisting conditions, such as autoimmune diseases and diabetes, face increased health risks during pregnancy. To stay positive during a high-risk pregnancy, it is essential to relax and trust your healthcare team, who are working towards a successful delivery and healthy baby. Building a support system, such as family, friends, or support groups, can help you navigate this time. Psychologists or genetic counselors can also be helpful.

Focus on healthy habits like getting enough sleep, exercising regularly, and eating nutritious foods, which are more manageable and contribute to a healthy pregnancy. Prioritize self-care, practicing relaxation techniques like meditation and engaging in enjoyable activities daily to lift your spirits and improve your mood. These strategies can help you navigate the challenges of pregnancy and maintain a positive outlook.

What is a pre-existing condition in pregnancy?
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What is a pre-existing condition in pregnancy?

Pre-existing diseases in pregnancy are not directly caused by pregnancy but can worsen or pose a risk to the pregnancy. This risk can be exacerbated by the use of drugs during pregnancy to manage the disease. Women who wish to continue with a pregnancy require additional medical care from an interdisciplinary team, including specialists in the disorder and other practitioners. Chronic hypertension in pregnancy can lead to increased complications for both the mother and fetus, including pre-eclampsia, caesarean delivery, preterm delivery, low birth weight, and death.

Increasing rates of obesity and metabolic syndrome contribute to the increased prevalence of chronic hypertension and associated complications. Women with chronic hypertension before pregnancy are at an increased risk of complications such as premature birth, low birthweight, or stillbirth. High blood pressure treatment during pregnancy has been shown to decrease the incidence of severe hypertension, but there was no significant difference in pregnancy complications.

What is an existing health condition during pregnancy?
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What is an existing health condition during pregnancy?

Pregnant women with pre-existing medical conditions, such as anemia, autoimmune disorders, blood clotting disorders, cancer, diabetes, epilepsy, heart disease, hypertension, infectious diseases (HIV, cytomegalovirus, parvovirus), kidney disease, mental health issues, neurological disorders, nutritional issues, obesity, pulmonary conditions, and thyroid disorders, face complex and challenging gestational periods. Specialized care is necessary to reduce the risk of complications during pregnancy.


📹 Pre-Existing Diseases (PED) Explained | Health Insurance Concepts | Pre-Existing Diseases FAQs

A pre-existing disease (PED) refers to a medical condition that a person is already suffering from, before the policy purchase.


What Are Some Examples Of Pre-Existing Conditions?
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Rae Fairbanks Mosher

I’m a mother, teacher, and writer who has found immense joy in the journey of motherhood. Through my blog, I share my experiences, lessons, and reflections on balancing life as a parent and a professional. My passion for teaching extends beyond the classroom as I write about the challenges and blessings of raising children. Join me as I explore the beautiful chaos of motherhood and share insights that inspire and uplift.

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13 comments

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  • Hellow sir, Actually na to be honest mujhe fissure hai aur mere pas sufficient budget nhi hai surgery k liye toh me soch rha tha ki kyu na me insurance kra k ek health card banwa lu apna aur fir kisi bhi hospital me jaake apna treatment kra lu kra lu par apki ki ye pre-existing disease ka article dekh k confuse ho gya me. Toh kya ab aap suggest kr skte hai mujhe iske regarding..? Aap sincere and knowledgeable person lag rhe hai mujhe isiliye aapse advice maang rha hu.!

  • What if someone has already hidden his pre existing disease in policy and its 3-4 years running? Someone did not disclose PED as he was guided that PED will be taken care of automatically after the waiting period so its not important to disclose. What should one do now to disclose his PED to insurer??? PED was detected 6 years ago and policy was taken 3 years ago. Wont his policy be terminated? Or will company reconsider it ? Please tell in details. What’s the way out?

  • secondly sir, i have no any other pre existing dieses but on last 5th and 6th my BP shoot up may be due to I heared about operation. Secondly they have given me BP tablets for 15 days i.e. upto 30th to continue. So now my BP will be treated as pre dieses during coming renewal on 12th Dec’ 23…. Hemalini Patel

  • Sir, mujhe parents ka policy me waiting period lagega kya???? Mere parents ka pre existing deases 2019 me the, aur maine 2023-24 ko reliance ka policy lia tha, usaka waiting perios 3 years ka hai, and abhi 1 year ho chuka hai, aur abhi mai kuch reasons se use port kar raha hu, to aap ne bataya ki 4 years se pahale ka deases hai to waiting period nahi lagega, but kya is case me mujhe port karane ke bad waiting period lag sakata hai kya???

  • Sir, I had a TB of Spine 12 years ago. When I disclose this to insurance companies, they reject my application. Tried with HDFC Ergo and Acko. I disclosed this as my insurance advisor at Ditto asked me to do so. Also, please share source of the information provided that diseases older than 4 years need not be disclosed.

  • My father had open surgery for kidney stone 13 years ago. In 2022 and 2023 got health insurance in HDFC ergo. Then ported to Star Health Insaurance and in both companies does not disclosed about kidney stone surgery. And few days ago got admitted in hospital for kidney swelling problem and went through a minor operation admitted for 2days in hospital. And i want to claim expenses Will i get claim from star ?

  • I purchased my health insurance in 2019 and continue till now, no claim so far. In 2022 while complementary free health done through insurance policy there was abnormal in ECG, so I consult cardiologist and came to know that there is issue in my heart ( aurtic valve regurgitation) in next couple of months my insurance renewal time is coming. Should i declare my health issues in the time of renewal this time. will this considered as pre- existing disease?? Kindly guide me if possible.

  • I’ve a corporate policy. Hip dislocation surgery has been done of my daughter, during procedure doctor installed the plate with her leg bone. My question is Would Removal of femur plating covered in insurance policy? Could i claim for Removal of femur plating? If not, is there any insurance policy which cover this?

  • Sir Namaskar Suppose some one taken health insurance for family of four. One person of family developed a critical illness like say brain tumor after taking the policy for say five year. After 6th year of starting of health insurance or say next year the person tried to increase the coverage amount. Is it possible or not. As now brain tumor will be treated as pre existing diseases. If coverage amount will not be increased then what are the options. Is Co-pay is option.

  • sir, i m having 2 lacs Mediclaim policy of Iffico tokyo which is going to expire on 12.12.2023. I have been detected some utrus issues in June’23, and i am under treatment for the same. Now on 3oth Nov’23 I have to undergone for hysterotomy/urus removal. And when I asked insurance agency about reimbursement/ claim to be filed after operation but they said this operation is not covered in my policy because it might be pre-diseases. It means I will not be able to get claim?? secondly, on 12th Dec’23 when I am going to renew policy should I continue with this Iffico tokyo or should buy another agency ?? pl. replay soon……

  • Please help me to clarify : I have a problem of my left eye retina in the year 2013. I have taken a health insurance for Rs. 5.00 from CARE Company in the year 2019 March 18th. By the time of taking this policy I have not informed regards my previous eye problems as preexisting conditions. I have continued my policy for the last 5 years by paying yearly premiums without any claims. But in the month of February 2024, I have got a right eye problem of retina. The concern Hospital has claimed for the payments for the treatment of the eye with all the previous medical records. Now the Care Company has rejected the claim by stating that ” hidden the material fact/ not disclosed the preexisting medical conditions. After few days the company has canceled my health insurance policy by stating the same facts. My previous health problems had in year 2013.. Taken health policy from Care in the year 2019 March 18th. I have continued my policy from 2019 to 2024 for 5 years. Please help me how to overcome this problem.

  • सर, हमने ५ साल से ज्यादा तक हमारे महाराष्ट्र बँक सेविंग अकाउंट से फॅमिली मेडिक्लेम पॉलिसी ले रखी थी “महाआरोग्य” ज्यो युनायटेड इंडिया इन्शुरन्स की तरफ से अभी उन्होंने उनका टायप था पर अभी हमे बताये बीना वो टाइप कॅन्सल कर दिया है तब हमे अब हमारी पॉलिसी कंटिन्यू कैसे करना है ? अभी तो पोर्ट भी नही कर सकते तो हम कया करे ? कृपया कुछ सोल्युशन बताईये ! 🙏

  • Sharing my experience. I bought an mediclaim from IOB bank linked WITH APOLLO Munich in 2019. It was without any medical check up for customer of bank. Then they have shifted it to HDFC Ergo. I have claimed many times for some flu related admission. In 2023 they said me to port my hdfc policy to niva bupa and just after 2 month my dad was detected with prostate cancer and NIVA bupa has cancelled my policy by stating that you have not told us about your dad has asthma. So we are cancelling the policy. So my suggestion to all of you is not to port your old policy in any circumstances.

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